Reviews

Feb 05, 1985

new internationalist 144 February 1985

NEW BOOKS

Dissenters are not usually as organised or informed as their bureaucratic opposition. This month we review books which offer advice to campaigners and look at the latest product from a good source of information for activists.

Editor: Anuradha Vittachi

Tips for trouble makers

Pressure - the A to Z of Campaigning in Britain by Des Wilson Heinemann 1984, £4.95

Changing the world for the better is not easy. At the very least it requires organising flair, which is why two new books containing the distilled wisdom of two practitioners of the organiser’s art. Des Wilson and Sue Ward, are so welcome.

Veteran lobbyist Des Wilson is a New Zealander who has campaigned in Britain since the 1960s, initially as director of Shelter, the campaign for the homeless.

Today he is chairperson of both Friends of the Earth and the Committee for Freedom of Information, as well as leading the pressure group for lead-free petrol.

Nobody is better qualified to write about pressure groups and Wilson reveals some fascinating insights into the successes of housing and environmental campaigning. Sue Ward, a former trade union organiser, provides some very practical hints for the grass roots campaigner from organising public meetings, through holding demonstrations to arranging festivals.

Both volumes are to be dipped into by the busy activist for useful bits of advice, But Wilson’s offering, if you can stand his egocentricity, is also an entertaining read all the way through.

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I wanted to send whole chunks of his book to friends in the pressure group business who so patently do not follow his advice on professionalism, efficient administration and keeping their particular pet issue in perspective. Like Wilson I too shudder when I meet the full - time campaigner who is so busy they have not taken a holiday in three years.

‘There isn’t enough humour in pressure group activity in Britain and that’s a pity’, he writes.

Wilson’s advice to pressure groups at national and local level is to be professional; in the lay-out of your printed materials, your relations with the press and in the quality of your research. Work out in advance what you want to achieve and be realistic, he cautions.

But the author admits that there is a lot of luck in most effective campaigns.

With the lead-free petrol campaign. CLEAR, for example, he describes receiving a leaked copy of a circular to civil service departments from Sir Henry Yellowlees, the chief medical officer at the Home Office. It stated that even very low levels of lead in the blood can affect the IQ and that petrol is a major cause of lead in the blood.

Wilson describes how he sat on the letter for some weeks before deciding to release it to The Times as an exclusive when the news would make most impact. CLEAR was launched in January 1982 and by April 1983, despite a vigorous road and car industry lobby, the Government decided to progressively ban lead from petrol.

It was the fortuitous screening on BBC television of the documentary ‘Cathy Come Home’ by Jeremy Sandford, about homelessness, which gave Shelter a timely public boost. But successful campaigns also need somebody like Des Wilson, with a feel for the way newspapers and the media work, to take full advantage of such luck.

Sue Ward’s book is best on our campaigning rights under the law and the powers of police. She is informative about the increased powers to arrest protestors in Britain under the new Police and Criminal Evidence Act, due to come into force later in 1985.

She is much more down to earth and has plenty of facts for grass- roots activists, such as how much somebody receiving Supplementary Benefit in Britain can earn without losing the state income. There are valuable check lists for planning marches, lobbies and petitions, for instance, and a delightful section on what to do when there are disasters.

It is disappointing that neither author, whose advice coincides more often than not, is prepared to explore how far pressure group politics can actually succeed.

Friends of the Earth’s much publicised dumping of empty bottles on the doorstep of Schweppes Ltd led not to returnable bottles but ‘bottle-banks’ to collect broken glass. There is more homelessness now in London than when ‘Cathy Come Home’ was first televised. There is less lead in petrol but 6,000 people a year are still killed on Britain’s roads.

Changing the world is hard. But both these books should help us do it.

Seen on the television news, natural disasters are cruel and unusual events, striking almost at random.

The theme of Natural Disasters, a new Earthscan paperback which will be useful to people involved in any way in development work, is that things are not this simple. Anders Wijkman, head of the Swedish Red Cross, and Earthscan’s Lloyd Timberlake look at the many types of natural disaster and at disaster relief and development practices. They conclude that natural disasters are being encouraged and exacerbated by present practices in the Third World, that disasters strike preferentially at the poorest.

As well as being anything but random, disasters are not rare, and are indeed becoming more common. In the 1960s there were 54 a year; in the 1970s, 81. Deaths per year rose from 23,000 to 143,000, and the numbers affected from 28 million to 48 million. This does not seem to have been the result of radical changes in the Earth’s weather, in geology or in the other direct causes of disasters. Instead, it has happened because of human intervention in the normal processes of avoiding and coping with natural disaster.

Examples abound in Wijkman and Timberlake’s work of ways in which new developments are making disasters more numerous and more damaging. Landslides used to kill people in the Alps - now this is rare. But in the Third World, the inequitable distribution of land means that poor people are living on steeper, more mobile slopes, so that theirs are the houses which are demolished in floods and earthquakes.

Martin Ince

CLASSICS

Limits to Medicine...being the book that defrocked the high priests of medicine.

The hospital in which I nurse has so few staff that a ward was closed last summer, ostensibly for ‘redecoration’ - though in fact to allow us to be shuffled round other wards where the situation was even more desperate.

Yet hours are spent vigorously debating the computerization of the hospital’s wards and the Health Authority to which we belong is the proud possessor of a ‘magnetic particle echo scanner’ a diagnostic plaything for which the magnets alone cost half a million dollars.

Most people say we are the victims of temporary financial stringencies. Ivan Illich would argue that our values are so distorted that we have reached our ‘medical nemesis’.

Illich, a perennial critic of establishments and orthodoxies, launches in Limits to Medicine a savage attack on the high priesthood of the medical profession. Doctors and their sidekicks, he says, have appropriated much of the private significance of our lives. From childhood to old age our rites of passage have been transformed into bizarre medical rituals. Parents are darkly warned that they ‘risk’ a home birth at their peril. Mothers must go into hospital to go into labour. They can no longer trust their own perceptions and won’t even believe they feel a contraction unless it is confirmed on the read-out of the Hewlett-Packard monitoring system. Death likewise - a terminal experience of attachment to cardiac monitor.

Birth and death have become ceremonials for white-robed doctors. But what good has it done us? Our perinatal mortality rate is no better than China’s, where they do very nicely without Hewlett-Packard.

When the British National Health Service was established it was believed that costs would fall in the long run as greater diagnostic and curative ability reduced the morbidity of the population. This has been proved utterly wrong. Neither our skills nor our equipment have saved us from chronic illness or the appallingly unloved burden of geriatrics. And high-tech units have been almost totally defeated in their attempt to reduce coronary fatalities. Finally and ludicrously we are discovering previously undreamt-of diseases in formerly healthy sections of the population.

In preventative medicine, some screening (cervical smears, for instance) may, if better organized, be worthwhile. But the vogue for computerized general screening of workforces has been shown in no way to reduce sickness rates. Expensive Medical Techniques have a terrible cumulative power. If they are available, we must have them - though two thirds of hospital construction costs are accounted for by equipment that becomes obsolete in ten years. Too bad if our local day-centre for the elderly has had to close for lack of funds.

In the USA such is the warped logic of this technological imperative that the hospitals have to buy all the latest gadgetry in order to exist at all: if they did not, doctors and their patients would soon move elsewhere. In consequence there are now often a dozen vastly expensive scanners in an area of a few square miles. And yet, Illich points out, in that same United States, home of unquestionably the most technically skilful medicine the world has ever seen, life expectancy has actually begun to fall. God forbid we should export such a medicine to countries where lives are short enough already - yet that is exactly what we are doing.

The World Health Organisation itself espouses ‘the deprofessionalisation of primary health care’ as the most important single step in raising national health levels. Yet year by year the grip of the professions tightens. The actual number of medical para-professions steadily grows as new specialities emerge. each demanding the taxpayer’s support as of right.

Lest we imagine our situation new, Illich takes us back to sources: to Prometheus, primitive symbolism, the hubris of the priest who confronts fate on society’s behalf. He looks also to that fast-closing future of psychological, environmental and genetic manipulation - engineering for a plastic womb’. He tells us to reclaim decisions about our own health, to resist categorisation, to ‘die well’ according to our own lights, and he does so with a breathtaking range of reference - historical, cultural, scientific and economic. For we are all health consumers, and ‘Limits to Medicine’ is about us all.